A prostate puncture biopsy will do pathology on each of the 14 prostate tissue specimens. If only one is a prostate cancer and the other 13 are normal, this indicates that the tumor is relatively limited; if all 14 specimens are prostate cancer, this indicates that the tumor is larger, has spread invasively, and the prognosis is worse.
In general, men over 45 years of age should routinely have a prostate specific antigen (PSA) test every year. If the PSA is significantly abnormal or repeatedly and persistently elevated on multiple retests, then a multi-point puncture biopsy of the prostate positioned by ultrasound should be done for early detection, diagnosis, and treatment of prostate cancer.
After prostate puncture biopsy, postoperative interpretation of the pathology report is important and contains a wealth of information for the clinical urologist to make choices about the patient’s treatment options. A 12+2 point puncture is usually performed, including 6 points each in the right and left lateral lobes of the prostate and 2 points in the apical part of the prostate. The pathology department will perform pathological sections on each of the 14 prostate tissue specimens. Each section is reported to include:
- Is it prostate cancer? Prostate hyperplasia? Inflammation of the prostate?
- If it is prostate cancer, what is the Gleason score? Usually 6 to 9. A higher score means more malignant and a worse prognosis; a lower score means less malignant and a better prognosis.
- If it is prostate cancer, has it invaded the vascular nerve envelope, etc. If it has, it means poor prognosis.
Some people have 14 puncture specimens and only one is prostate cancer and the other 13 are normal, which indicates a more limited tumor. In some people, all 14 specimens may be prostate cancer, which indicates that the tumor is larger, has spread invasively, and has a poorer prognosis.
As a patient, and as a family member, the interpretation of the pathology report is fine as long as it is properly understood. In contrast, as urologists and oncologists, the pathology report provides important information that can guide the physician in making the correct or most appropriate choice for the patient’s treatment.